Sweetened beverages and risk of frailty among older women in the Nurses’ Health Study: A cohort study

Background Consumption of sugar-sweetened beverages (SSBs) has been consistently associated with a higher risk of obesity, type 2 diabetes, cardiovascular disease, and premature mortality, whereas evidence for artificially sweetened beverages (ASBs) and fruit juices on health is less solid. The aim of this study was to evaluate the consumption of SSBs, ASBs, and fruit juices in association with frailty risk among older women. Methods and findings We analyzed data from 71,935 women aged ≥60 (average baseline age was 63) participating in the Nurses’ Health Study (NHS), an ongoing cohort study initiated in 1976 among female registered nurses in the United States. Consumption of beverages was derived from 6 repeated food frequency questionnaires (FFQs) administered between 1990 and 2010. Frailty was defined as having at least 3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 years from 1992 to 2014. During 22 years of follow-up, we identified 11,559 incident cases of frailty. Consumption of SSBs was associated with higher risk of frailty after adjustment for diet quality, body mass index (BMI), smoking status, and medication use, specifically, the relative risks (RRs) and 95% confidence interval (95% CI) for ≥2 serving/day versus no SSB consumption was 1.32 (1.10, 1.57); p-value <0.001. ASBs were also associated with frailty [RR ≥2 serving/day versus no consumption: 1.28 (1.17, 1.39); p-value <0.001]. Orange juice was associated with lower risk of frailty [RR ≥1 serving/day versus no consumption: 0.82 (0.76, 0.87); p-value <0.001], whereas other juices were associated with a slightly higher risk [RR ≥1 serving/day versus no consumption: 1.15 (1.03, 1.28); p-value <0.001]. A limitation of this study is that, due to self-reporting of diet and frailty, certain misclassification bias cannot be ruled out; also, some residual confounding may persist. Conclusions In this study, we observed that consumption of SSBs and ASBs was associated with a higher risk of frailty. However, orange juice intake showed an inverse association with frailty. These results need to be confirmed in further studies using other frailty definitions.

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A Prospective Cohort Study of Vitamins B, C, E, and Multivitamin Intake and Endometriosis

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.5301/je.5000151 ◽

2013 ◽

Vol 5 (1) ◽

pp. 17-26 ◽

Cited By ~ 16

Author(s):

Anne Marie Darling ◽

Jorge E. Chavarro ◽

Susan Malspeis ◽

Holly R. Harris ◽

Stacey A. Missmer

Keyword(s):

Cohort Study ◽

Vitamin E ◽

Vitamin C ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

B Vitamins ◽

Food Sources ◽

Health Study ◽

Protective Mechanism ◽

Incident Cases

Purpose Diet is a potentially modifiable risk factor for endometriosis. It has been hypothesized that vitamins C, E, and the B vitamins may influence factors involved in the pathogenesis of endometriosis, such as oxidative stress and steroid hormone metabolism. In this large, prospective cohort study, we examined the relation between intake of vitamins C, E, the B vitamins, and the use of multivitamin supplements and diagnosis of endometriosis. Methods Data were collected from women in the Nurses' Health Study II between 1991 and 2005. Diet was assessed via food frequency questionnaire. Incidence rate ratios (RR) and 95% confidence intervals (CI) were estimated using time-varying Cox proportional hazards models. Results A total of 1383 incident cases of laparoscopically-confirmed endometriosis were observed among 70,617 women during 735,286 person years of follow-up. Intakes of thiamine (B1) (RR = 0.84, CI = 0.72-0.99; P-value, test for linear trend[P] = 0.04), folate (B9) (RR = 0.79, CI = 0.66-0.93; P = 0.003), vitamin C (RR = 0.81, CI = 0.68-0.95; P = 0.02), and vitamin E (RR = 0.70, CI = 0.59-0.83; P<0.0001) solely from food sources were inversely related to endometriosis diagnosis. However, intakes of these nutrients from supplements alone were unrelated to endometriosis. Conclusion Thiamine, folate, vitamin C, and vitamin E from food sources are inversely related to endometriosis risk. Our results suggest that the protective mechanism may not be related to the nutrients themselves but rather other components of foods rich in these micronutrients or factors correlated with diets high in these vitamin-rich foods.

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Nut and Peanut Butter Consumption and Mortality in the NIH-AARP Diet and Health Study (P18-001-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-001-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Vineeth Amba ◽

Gwen Murphy ◽

Arash Etemadi ◽

Shao Ming Wang ◽

Christian Abnet ◽

...

Keyword(s):

Peanut Butter ◽

The United States ◽

Health Study ◽

Differential Mortality ◽

Inverse Association ◽

Funding Sources ◽

Hazard Ratios ◽

Disease Mortality ◽

Specific Mortality ◽

Risk Of Cancer

Abstract Objectives Although previous studies have shown inverse associations between nut consumption and mortality, the associations between nut consumption and less common causes of mortality have not been studied. Additionally, approximately 50% of peanut consumption in the United States is through peanut butter, but the association between peanut butter consumption and mortality has not been thoroughly investigated. The objective of this study was to examine the associations between nut and peanut butter consumption and the risk of all-cause and cause-specific mortality. Methods The NIH-AARP Diet and Health Study recruited 566,398 individuals aged 50–71 at baseline in 1995–1996. A food-frequency questionnaire was used to evaluate nut and peanut butter consumption. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for mortality using the non-consumers as reference groups. Results After excluding subjects with chronic diseases at baseline, there were 64,464 deaths with a median follow-up time of 15.5 years. We observed a significant inverse association between nut consumption and overall mortality (HR C4 vs C1 = 0.78, 95% CI = 0.76, 0.81). Nut consumption was significantly associated with reduced risk of cancer, cardiovascular, respiratory, infectious, renal and liver disease mortality, but not with diabetes, and Alzheimer's disease mortality. We observed no significant associations between peanut butter consumption and all-cause (HR C4 vs C1 = 1.00, 95% CI = 0.98, 1.04) and cause-specific mortality. Conclusions In a middle-aged US population, nut intake was inversely associated with all-cause mortality and certain types of cause-specific mortality. However, peanut butter consumption was not associated with differential mortality. Funding Sources This study was supported by the Intramural Research Program of the National Cancer Institute, NIH.

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Urinary isoflavonoids and risk of type 2 diabetes: a prospective investigation in US women

British Journal Of Nutrition ◽

10.1017/s0007114515003359 ◽

2015 ◽

Vol 114 (10) ◽

pp. 1694-1701 ◽

Cited By ~ 20

Author(s):

Ming Ding ◽

Adrian A. Franke ◽

Bernard A. Rosner ◽

Edward Giovannucci ◽

Rob M. van Dam ◽

...

Keyword(s):

Type 2 Diabetes ◽

Urinary Excretion ◽

Hormone Replacement ◽

Health Study ◽

Inverse Association ◽

Validated Questionnaire ◽

Menopausal Women ◽

Post Menopausal ◽

Incident Cases

AbstractTo examine the association between urinary excretion of isoflavonoids and risk of type 2 diabetes (T2D), we conducted a nested case–control study among 1111 T2D pairs identified during 1995–2008 in the Nurses’ Health Study (NHS) and NHSII, who were free of diabetes, CVD and cancer at urine sample collection. Urinary excretion of daidzein and genistein, as well as their metabolites O-desmethylangolensin (O-DMA), dihydrogenistein (DHGE) and dihydrodaidzein (DHDE) was assayed using liquid chromatography MS. Self-reported T2D incident cases were confirmed using a validated questionnaire. Higher urinary excretion of daidzein and genistein was associated with a lower risk of T2D in the combined cohorts. Comparing extreme tertiles of the urinary markers, the OR of T2D were 0·71 (95 % CI 0·55, 0·93) for daidzein and 0·74 (95 % CI 0·56, 0·97) for genistein, although the test for linear trend was not significant for genistein (Ptrend=0·03 and 0·15, respectively). DMA, DHDE and DHGE were non-significantly associated with a lower T2D risk. The inverse association of daidzein with T2D risk was stronger among post-menopausal women who did not use hormone replacement therapy (Pinteraction=0·001): the OR was 0·58 (95 % CI 0·34, 0·97) comparing extreme tertiles among these women. In conclusion, urinary excretion of isoflavones was associated with a lower T2D risk in US women, especially among post-menopausal women who did not use hormone. Further research is warranted to replicate these observations among western populations with similarly low overall isoflavone intake.

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Effects of alcohol consumption and smoking on risk for RA: results from a Swedish prospective cohort study

RMD Open ◽

10.1136/rmdopen-2020-001379 ◽

2021 ◽

Vol 7 (1) ◽

pp. e001379

Author(s):

Louise Hedenstierna ◽

Rino Bellocco ◽

Weimin Ye ◽

Hans-Olov Adami ◽

Torbjörn Åkerstedt ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Synergistic Effect ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cox Proportional Hazards ◽

Smoking Habits ◽

P Value ◽

Inverse Association ◽

Incident Cases

ObjectiveSeveral, but not all studies, have shown a dose-dependent inverse association with alcohol consumption and rheumatoid arthritis (RA), whereas smoking is an established risk factor for RA. We aimed to study the association between alcohol consumption and RA incidence and investigate a potential interaction between alcohol and smoking habits, regarding RA incidence.MethodsWe used a prospective cohort study, based on 41 068 participants with detailed assessment of alcohol intake, smoking and potential confounders at baseline in 1997. We ascertained a total of 577 incident cases of RA during a mean of 17.7 years of follow-up through linkage to nationwide and essentially complete databases. Multivariate Cox proportional hazards models were used to estimate HR with 95% CI. Interaction on the additive scale between alcohol and smoking was estimated by calculating the attributable proportion due to interaction (AP).ResultsOverall, alcohol consumption was associated with a 30% reduced incidence of RA (HR 0.69, 95% CI 0.55 to 0.86) with a dose–response relationship (p value for trend <0.001) which remained significant after stratification by age and smoking habits. The positive association between smoking and RA incidence was reduced with increasing alcohol consumption (p value for trend <0.001). A synergistic effect was observed between alcohol and smoking (AP 0.40, 95% CI 0.15 to 0.64), indicating that 40% of the cases among the double exposed are due to the interaction per se.ConclusionsOur findings suggest an inverse association between alcohol consumption and RA incidence, and a synergistic effect between alcohol and smoking.

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Evaluating the role of orange juice, HESPERidin in vascular HEALTH benefits (HESPER-HEALTH study): protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2021-053321 ◽

2021 ◽

Vol 11 (11) ◽

pp. e053321

Author(s):

Marie-Anne Verny ◽

Dragan Milenkovic ◽

Nicolas Macian ◽

Bruno Pereira ◽

Rémy Evrard ◽

...

Keyword(s):

Orange Juice ◽

Vascular Function ◽

Controlled Trial ◽

Experimental Studies ◽

Epidemiological Studies ◽

Fruit Juices ◽

Health Study ◽

Double Blind ◽

Adverse Health Effects ◽

Randomised Controlled

IntroductionAlthough epidemiological studies associate the consumption of sugary beverages with adverse health effects, human experimental studies have demonstrated substantially different metabolic responses when 100% fruit juices are compared with artificial beverages. Fruit juices do not just provide sugars and associated calories, but they are also rich in bioactive compounds. Flavanones are bioactives specifically and abundantly found in citrus foods, with hesperidin as the major representative in sweet oranges. Flavanone intake has been associated with a lower incidence of mortality from cardiovascular disease (CVD). However, clinical evidence are too scarce to confirm the vasculoprotective effects of 100% orange juice (OJ) presumably mediated by flavanones and thereby do not allow firm conclusions to be drawn about their efficacy.Methods and analysisThe HESPER-HEALTH study aims to assess the efficacy of OJ in improving vascular function and the contribution of hesperidin to these effects. This double-blind, randomised, controlled, crossover study will be carried out in 42 volunteers predisposed to CVD, based on age and on overweight. It includes three 6-week periods of consumption of 330 mL/d of OJ versus control drinks with and without hesperidin at a dose in agreement with a daily OJ serving (approx. 200–215 mg). The primary outcome is endothelial function, assessed by flow mediated dilation, with measurements performed at fasting and postprandially in response to a challenge meal. The secondary outcomes include bioavailability and metabolism of flavanones, changes in other markers of vascular function, systemic biomarkers of cardiovascular risk, endothelial dysfunction and inflammation, vitamin C and carotenoids status, anthropometry and body composition, gut microbiota composition, nutrigenomic response and in oxylipin profiling.Ethics and disseminationThis ongoing study was approved by the Ethics committee Sud-Est III, Bron, France on 17 November 2020. The trial is registered on ClinicalTrials.gov. The results will be disseminated in peer-reviewed journals.Trial registration numberNCT04731987; Pre-results.

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Abstract P380: Steps Per Day and Step Intensity are Associated With a Lower Risk of Diabetes. The Hispanic Community Health Study / Study of Latinos (HCHS/SOL)

Circulation ◽

10.1161/circ.141.suppl_1.p380 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Carmen Cuthbertson ◽

Christopher Moore ◽

Daniela Sotres-Alvarez ◽

Gerardo M HEISS ◽

Olga Garcia-Bedoya ◽

...

Keyword(s):

Lower Risk ◽

Smoking Status ◽

The United States ◽

Incidence Rates ◽

Incident Diabetes ◽

Health Study ◽

Inverse Association ◽

Hispanic Community ◽

Steps Per Day ◽

Rate Ratios

Introduction: Physical activity has been associated with a lower risk of diabetes but less is known about the association of steps per day (steps/d) and step intensity with incident diabetes. Hypothesis: We hypothesized an inverse association between both number of steps/d and time spent at a stepping rate corresponding to purposeful steps ( > 40 steps/min) with the risk of incident diabetes. Methods: We included 7247 participants free of diabetes at baseline in the prospective HCHS/SOL cohort of Latinos sampled from four communities in the United States. Steps/d and minutes per day (min/d) at a stepping rate > 40 steps/min were assessed at baseline with the Actical accelerometer (2008-2011), and incident diabetes was ascertained at a follow-up visit (2014-2017). The association of steps with incidence rates (per 1,000 person-years) of diabetes and incidence rate ratios (IRR) was estimated using Poisson regression, accounting for the sampling design and adjusted for age, ethnicity, gender, education, smoking status, alcohol intake, and accelerometer wear time. Results: The average age at baseline was 38 years (range 18 - 74 years) and 52% were female. Over a median of 5.9 years, 850 participants (9%) developed diabetes. The median step count was 7360 steps/d and the median minutes per day at a stepping rate of > 40 steps/min was 55 minutes. For each 1,000 step/d increment, the risk of diabetes was 5% lower (Table, IRR= 0.95(95% confidence interval (CI) 0.88, 1.02)). Compared to adults who engaged in 2,000 steps/d, those who engaged in 5,000 and 10,000 steps/d had a 13% and 26% lower risk of diabetes. The risk of diabetes was 5% lower (IRR=0.95 (95% CI 0.89, 1.00)) per 10 minute increase in time spent at a stepping rate > 40 steps/min. Compared to adults who spent 10 min/d at > 40 step/min, those who spent 30, 60, and 120 min/d had a 10%, 20%, and 32% lower risk of diabetes. Conclusion: The number of steps per day and time spent at a stepping rate that corresponds to purposeful steps are inversely associated with the risk of developing diabetes among adults.

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Sweetened beverages and risk of frailty among older women in the nurses' health study

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.09.627 ◽

2020 ◽

Vol 40 ◽

pp. 615

Author(s):

E.A. Struijk ◽

F. Rodriguez-Artalejo ◽

T.T. Fung ◽

W.C. Willett ◽

F.B. Hu ◽

...

Keyword(s):

Older Women ◽

Health Study ◽

Sweetened Beverages

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Independent and Synergistic Associations of Biomarkers of Vitamin D Status With Risk of Coronary Heart Disease

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.117.309548 ◽

2017 ◽

Vol 37 (11) ◽

pp. 2204-2212 ◽

Cited By ~ 10

Author(s):

Lu Qi ◽

Wenjie Ma ◽

Yoriko Heianza ◽

Yan Zheng ◽

Tiange Wang ◽

...

Keyword(s):

Vitamin D ◽

Coronary Heart Disease ◽

Heart Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Health Study ◽

Inverse Association ◽

Hydroxyvitamin D ◽

Chd Risk ◽

Incident Cases

Objective— To comprehensively evaluate the independent associations and potential interactions of vitamin D–related biomarkers including total and bioavailable 25-hydroxyvitamin D (25OHD), VDBP (vitamin D binding protein), and parathyroid hormone (PTH) with risk of coronary heart disease (CHD). Approach and Results— We prospectively identified incident cases of nonfatal myocardial infarction and fatal CHD among women in the Nurses’ Health Study during 20 years of follow-up (1990–2010). Using risk-set sampling, 1 to 2 matched controls were selected for each case. The analysis of 25OHD and PTH included 382 cases and 575 controls; the analysis of VDBP included 396 cases and 398 controls. After multivariate adjustment, plasma levels of total 25OHD, bioavailable 25OHD, and PTH were not significantly associated with CHD risk. VDBP was associated with a lower CHD risk with an extreme-quartile odds ratio of 0.60 (95% confidence interval, 0.39–0.92; P trend=0.02). When examining the biomarkers jointly, a significant, inverse association between 25OHD and CHD was observed among participants with higher PTH levels ( P for interaction=0.02). The odds ratio (95% confidence interval) comparing the highest quartile of 25OHD to lowest was 0.43 (0.23–0.82; P trend=0.003) when PTH levels were above population median (35.3 pg/mL), whereas among the rest of participants the corresponding odds ratio (95% confidence interval) was 1.28 (0.70–2.36; P trend=0.43). Conclusions— Our data suggest that higher 25OHD levels were associated with a lower CHD risk when PTH levels were high, whereas no association was observed for participants with low PTH levels. VDBP but not bioavailable 25OHD was independently associated with lower CHD risk.

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The relationship between handedness and risk of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458509102622 ◽

2009 ◽

Vol 15 (5) ◽

pp. 587-592 ◽

Cited By ~ 12

Author(s):

H Gardener ◽

K Munger ◽

T Chitnis ◽

D Spiegelman ◽

A Ascherio

Keyword(s):

Multiple Sclerosis ◽

Hand Preference ◽

The United States ◽

In Utero ◽

Health Study ◽

Unknown Etiology ◽

Left Handed ◽

Increased Risk ◽

Incident Cases ◽

The Relationship

Background Left-handedness has been studied as a marker for in-utero exposure to sex steroid hormones, and an increased risk of autoimmune and immune disorders among left-handed individuals has been suggested. Objective This study examines the relationship between hand preference and risk of multiple sclerosis, a presumed autoimmune disorder of unknown etiology. Methods The study population comprised participants in the Nurses’ Health Study, an ongoing prospective cohort study of 121,701 female nurses in the United States with followup from 1976 to 2002. The nurses were asked to report their natural hand preference (right, left, ambidextrous, forced to change). Results During followup 210 incident cases with multiple sclerosis were confirmed. A 62% increased risk of multiple sclerosis was observed among women who were naturally left handed as compared to those who were naturally right handed (95% CI: 1.04–2.53). Conclusions This study suggests a modest increase in risk of multiple sclerosis among left-handed women. Further investigation of this relationship is suggested in other populations including both males and females. While the current results suggest that prenatal exposure to sex hormones may play a role in multiple sclerosis risk, direct examination of the relationship between in-utero hormone exposure and hand preference is necessary before any conclusions can be drawn.

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